The overall aim of this study is to test the safety and short- and long-term efficacy of maintaining nitrogen balance with different combinations of severe and moderate caloric restriction and low and high intensity aerobic exercise in obese patients with coronary artery disease (CAD). Thirty-two (of the 36 planned) subjects have completed the study, and 4 still need to complete their 2-year follow-up visits. Preliminary results after one year show that undiagnosed diabetes and hyperinsulinemia are prevalent in these patients. Diet + exercise improves insulin sensitivity and reduces insulin levels, which have been associated with CAD.